Advice on metyrapone supply issue
13 Feb 2019
There is a manufacturing supply issue with metyrapone (not UK-specific) that is likely to last some months. As the UK uses more of this drug than ketoconazole for Cushing’s patients this is clearly a big issue and some patients may need switching to ketoconazole, or to be considered for other treatments.
The medical community might be able to influence a reduction in metyrapone use by altering some prescribing practice. This would ensure more is available for patients who are on longer term treatment or have very severe disease. For patients who are awaiting pituitary surgery in centres that pre-treat, please consider using either ketoconazole or not treating at all (with or without bringing pituitary surgery forward).
There is a finite supply of metyrapone in the UK, and until the manufacturing issue is resolved there will be no more than currently exists. On current forecasts this will last a couple of months or so.
HRA Pharma will write formally with more details shortly and the Society will disseminate this information as soon as possible.